Lynn A. Darby

Reducing Cardiovascular Risk Factors in Postmenopausal Women through a Lifestyle Change Intervention

BACKGROUND The impact of a 6-month lifestyle change intervention on cardiovascular risk factors in obese, sedentary, postmenopausal women was examined. A secondary aim of this investigation was to determine whether the addition of self-control skills training to an empirically supported lifestyle change intervention would result in greater cardiovascular risk reduction. METHODS Forty-four women were randomly assigned to receive either a lifestyle change or a lifestyle change with self-control skills intervention. Pretreatment and posttreatment weight loss, body composition, physical activity, cardiorespiratory fitness, diet, blood pressure (BP), blood lipids, and psychosocial functioning were assessed. Also, at 1-year posttreatment, weight loss, body composition, self-reported physical activity, and psychosocial functioning were assessed. RESULTS The women significantly increased their physical activity (+39.6%) and cardiorespiratory fitness (+13.5%) and reduced their body weight (-6.5%), fat mass (-7.4%), body fat (-2.4%), BP (SBP -6.2%, DBP -9.2%), total cholesterol (-7.4%), triglycerides (-16.5%), and low-density lipoprotein (LDL) cholesterol (9.1%) and improved their diet (p < 0.05). At the 1-year follow-up, women had regained approximately 63% of their posttreatment weight loss (p < 0.05), but had maintained their previous increases in physical activity. Additionally, there were no significant changes in fat free mass, body fat, anxiety, or depression between the end of treatment and 1-year posttreatment. The addition of self-control skills training did not significantly improve cardiovascular risk reduction. CONCLUSIONS Lifestyle change interventions may be an effective means for reducing cardiovascular risk in obese, sedentary, postmenopausal women. However, greater attention should be devoted to the maintenance of these positive lifestyle changes.

A randomized trial comparing two approaches to weight loss: differences in weight loss maintenance.

This study compared treatment outcomes for a new weight loss program that emphasized reducing unhealthy relationships with food, body image dissatisfaction, and internalized weight bias (New Perspectives) to a weight loss program that emphasizes environmental modification and habit formation and disruption (Transforming Your Life). Fifty-nine overweight and obese adults (body mass index ≥ 27 kg/m2) were randomly assigned to either a 12-week New Perspectives or Transforming Your Life intervention. Despite equivalent outcomes at the end of treatment, the Transforming Your Life participants were significantly more effective at maintaining their weight loss than New Perspectives participants during the 6-month no-treatment follow-up period.

Transforming your life: an environmental modification approach to weight loss.

This investigation compared a traditional behavioral weight loss program with a weight loss intervention emphasizing environmental modification and habit formation and disruption. Fifty-four overweight and obese adults (BMI ≥ 27 kg/m2) were randomly assigned to either a 14-week LEARN or TYL intervention. Forty-two participants completed the six-month follow-up assessment. Treatment outcomes between LEARN and TYL participants were equivalent. During the six-month no-treatment follow-up period, participants evidenced a 3.3 lb (SD = 9.2) weight gain. The TYL intervention appears to represent an attractive option for individuals seeking an alternative to the traditional behavioral approach to weight loss.

The Failure of Therapist Assistance and Stepped‐care to Improve Weight Loss Outcomes

Objective: This investigation was designed to examine whether: (i) individuals could successfully lose 5% of their body weight with minimal assistance, (ii) weight loss would be improved by the addition of therapist assistance, and (iii) individuals unsuccessful at losing 5% total body weight during the minimal assistance phase (with or without therapist assistance) would benefit from a weekly weight loss group.

The Effects of Cadence, Impact, and Step on Physiological Responses to Aerobic Dance Exercise

The physiological responses to aerobic dance exercise of varied impact (high, low), step (less arm movement vs. more arm movement), and cadence (124 vs. 138 beats.min-1) were investigated. Experienced, female aerobic dancers (N = 16) performed activities that combined the levels of impact and step for 3 trials of 8-min each. Dependent variables included heart rate, percentage of maximal heart rate, oxygen consumption, percentage of maximal oxygen consumption, and respiratory exchange ratio. Repeated measures analyses of variance indicated a significant Impact x Step interaction whereby oxygen consumption was greater for the high impact-less arm movement activity (jog), while the low impact-more arm movement activity (power jack) was greater for heart rate. The interaction of aerobic dance characteristics (e.g., impact, arm movement) that may alter physiological responses to aerobic dance exercise should be identified in future aerobic dance routines and studies.

Implications of a behavioral weight loss program for obese, sedentary women: a focus on mood enhancement and exercise enjoyment.

Abstract The benefits of a 6‐month behavioral weight loss program were investigated by examining mood changes after a graded exercise test (GXT), changes in exercise enjoyment, and the relation of mood and enjoyment to program success. Obese, sedentary, postmenopausal women completed a demographic questionnaire, and physical and psychological measures. Women who completed the program (n = 25) significantly decreased their body weight and body mass index and reported significantly less tension and confusion post‐GXT when measured both at the beginning and end of the program. Although their exercise enjoyment increased, their exercise‐related mood changes appeared to be independent of enjoyment. Finally, women who completed the program initially reported more positive mood changes post‐GXT than did dropouts (n = 7). In conclusion, mood alteration may be a factor leading to successful completion of a behavioral weight loss program by obese women

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

Background: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment. Methods: Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.5; female = 67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6 weeks, while the other half remained in their groups regardless of weight loss. Results: There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC = 4.9% vs. BWLP = 7.8%; p = .10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p < .01). Conclusion: There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.

Stepped-care in obesity treatment: Matching treatment intensity to participant performance

This investigation examined the effectiveness of a self-help (SH), stepped-care (SC) weight loss program. Based on a failure to achieve pre-assigned weight loss goals, participants were eligible to be stepped-up from a SH program to two levels of treatment intensity (weight loss group [WLG]; individual counseling [IC]) beyond SH. The primary outcome was change in body weight. Fifty-three overweight/obese adults (BMI≥27 kg/m(2); mean BMI of 37.3, SD=6.6, 89% Caucasian, and 77% female) participated in an 18-week weight loss intervention. During several phases of the investigation, those stepped-up to more intensive treatment lost comparable weight to those who were not stepped-up. Nevertheless, by the end of treatment, individuals who remained in SH (M=8.6%) lost a significantly greater percentage of weight than individuals who received SH+IC (M=4.7%; p<.05) and individuals in SH+IC lost a significantly greater percentage of weight than individuals who received SH+WLG+IC (M=1.6%; p<.05). While some individuals benefited from being stepped-up to greater intensity treatment, other individuals experienced little benefit. The application of SC principles to the treatment of obesity needs further study.

DIFFERENTIATED RATINGS OF PERCEIVED EXERTION AND PHYSIOLOGICAL RESPONSES DURING AEROBIC DANCE STEPS BY IMPACT/TYPE OF ARM MOVEMENT

Overall ratings of perceived exertion, i.e., undifferentiated RPE, are often used as indicators of exercise intensity during walking, jogging, and cycling; however, conflicting results concerning RPE during aerobic dance exercise have been reported, and the use of differentiated RPE, i.e., local RPE and central RPE, has not been investigated. The purposes of this study were to assess local, central, and over-all RPE, and physiological responses [heart rate (HR); % HRmax; absolute and relative VO2; % VO2 max, ventilation (VE), ventilatory equivalent (VE · VO2−1); and oxygen pulse] during aerobic dance exercise varied by Arm Movement (Static Arm vs Dynamic Arm) and Impact (High vs Low). Trained women (N = 25; max VO2 = 50.4± 7.5 ml · kg−1 · min.−1) completed four aerobic dance steps. No RPE were significantly correlated with heart rate or VO2; however, for all steps all RPE were significantly (r = .40–,62) correlated with VE · VO2−1or VE. No interactions were present for RPE or physiological variables, and main effects were noted for Impact and Arm Movement. All RPE were greater for High Impact and for Static Arm Movement. Because VE and VE · VO2−1 were correlated with Overall RPE for all steps, this may suggest that participants “attended to” perceived changes in respiratory phenomena during aerobic dance exercise. It appears that during combined arm-and-leg aerobic dance exercise the use of Overall RPE is sufficient to assess perceptual sensations associated with the intensity of the exercise. Changes in Overall RPE were proportionate to objective measures of exercise intensity, i.e., HR and VO2; however, it is recommended that both HR and Overall RPE be used to assess fully a participants objective and subjective responses during aerobic dance exercise.

Senior Adult Fitness Evaluation—A Research Project that Combined Research, Teaching, & Service

Abstract Young preprofessionals worked with older adults, who may complete tasks more slowly, may need instructions explained or repeated, and may require special interpretation of their results—all of which provided an opportunity of understanding for these students.